Gary Ashe: Modifying the Perfect Fit
August 2008 Issue
Gary Ashe knows what it means to put his life at risk. In 1969, at the age of 19, Ashe was sworn into service as an Army reservist by his father, Major Charles J. Ashe. After serving as a munitions inspector for ten years, he left the military for a civilian job that seemed to be a perfect fit, continuing with the same hazardous work at Fort Drum, New York. Ironically, it was not his job as an explosives expert that would forever change his life, but rather a back-road encounter just outside of the Army base.
An End to the 'Perfect Fit'
On a quiet weekend in July 1989, Ashe received an urgent summons from gun control on Fort Drum. One of the heavy weapons had jammed. Ashe had signed up to compete in a team golf tournament later that afternoon, but by the time he completed the inspection, the competition had begun, so he hopped on his motorcycle and headed for home. As Ashe rode home, an overloaded ten-wheeler was pulling out of a nearby shipping yard, headed for the same intersection as Ashe. Both drivers arrived simultaneously, but the truck failed to stop at the red light and collided with Ashe. It was another half-mile before the truck could come to a complete stop. Ashe was unconscious and severely injured.
|From left: Gregory, Kimberly, Barbara, and Gary Ashe.|
News of the accident reached Ashe's wife, Barbara, and his teammates on the golf course. When Barbara arrived at the hospital, it quickly became apparent that the goal of the emergency-room staff was to save Ashe's leg. Throughout the seven surgeries that followed, Ashe's time in the hospital became defined by pain, morphine, lack of appetite, weight loss, and uncertainty as to whether he would keep his limb. Eventually, the onset of gangrene dictated a high transfemoral amputation, which left him with circulatory and neural problems.
Twenty years later, Ashe sits at his kitchen table and tells his story, surrounded by family and friends in a house full of warmth and support. Although the events of his accident were tragic, grim nostalgia is absent from Ashe's story. Details of misfortune are followed by an encouraging comment from his supporters or an anecdote about a humorous prosthetic mishap.
Though the hospital had given Ashe a list of care providers whom he would be seeing, he later chose his own team. Fred Gill, PT, who had been a casual acquaintance on the golf course, eventually became Ashe's physical therapist and a subsequent lifelong friend. "Gill came out to the house and taught me how to walk and fall," Ashe says, laughing.
Gill recalls the struggles of getting his friend walking again. Gill countered Ashe's circulatory problems with water therapy and says that Ashe's first steps were taken on parallel bars made by a colleague of Ashe's at Fort Drum. "I can remember coming up here when we first began therapy, and Gary's kids were young," Gill says. "We used to make them gather up every pillow in the house and throw them on the floor; then the kids would get to knock him over so he could learn to fall. The kids loved that." Even after the physical therapy session ended and Gill had left, Ashe's children would sternly critique him when he would deviate from how "Mr. Gill said to do it."
Concurrently, Ashe sought out the expertise of Don Holmes, CPO, clinical director of prosthetics and orthotics at Northern Orthopedic Lab, Northern, New York. Holmes is past president of both the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) and the American Academy of Orthotists and Prosthetists (the Academy), as well as previous lead O&P researcher at NorthwesternUniversity. He has a private practice in the backcountry of New York but has stayed active in the quickly developing O&P profession. Holmes started Ashe with a preparatory prosthesis-a simple SACH foot with a manual knee lock-while Gary's residual limb became more mature. By 1991, Ashe had progressed to a more permanent prosthesis, plus a swim prosthesis constructed by Holmes.
Ashe's accident and subsequent rehabilitation didn't just affect Ashe, it affected his wife as well. She found herself adding yet another title to her already long list: mother, wife, worker, and now caregiver. She explains that often she would push Ashe to perform tasks at home out of sheer necessity, as she could not keep up with everything by herself. Also, the legal battle of his "open-and-shut case," which had begun shortly after the accident, dragged on until the settlement in 1993.
By 1994, Ashe was working with a personal trainer-Gill's son-and had reached his peak physical fitness level since the accident. However, it was difficult to go back into society's crowds due to his fragile balance. Phantom pain was also a constant struggle. Ashe describes it as a "grabbing" pain that would cause his residual limb to "jump all over the place."
In December 1999, Holmes asked Ashe to be his patient model at an Otto Bock HealthCare course introducing the C-Leg® in Buffalo, New York. At the time, this technology was new to the United States although it had been prototyped in Europe since 1993. At the conference, they swapped out Ashe's old knee for the C-Leg.
Ashe was one of the last patient models to be fit with the new unit. The following day, photographers were invited to watch the patient models traverse uneven terrain, walk step-over-step, and perform other, yet-to-be-heard-of feats. Ashe practiced with his trial unit through most of the night before the demonstration. Holmes recalls that Ashe was so impressed with the improved gait and reduced energy expenditure that the leg allowed, Ashe called his wife at 3 a.m., and the couple decided to commit all of their financial resources to obtaining a C-Leg for him.
The next morning, Ashe watched as his fellow patient models used a rail to guide them as they rode the prosthetic knee down a ramp. Not to be outdone because of his short time with the unit, Gary stuffed his hands in his pockets and began his descent into a new way of life, laughing when he saw Holmes "flip out."
Modification of Fit
Today, Ashe is on his second C-Leg, and the Ashe family has adapted to the "new fit" of life. Ashe and Barbara had a son, Gregory, in 1992. Ashe has played golf greens along the East Coast with Gill and donated his old prosthesis to the Syracuse Veterans Administration, where he also speaks to patients with new amputations. Ashe also serves on the Fort Drum Days board to ensure universal accessibility to its events. Technological advancements have allowed Ashe to go further physically than he would have been able to with a manually locking knee. However, Ashe stresses that the technology is only as good as the socket fit. In parallel, practitioner, patient, and family must be willing to spend the hours needed to modify both plaster and situation until they fit and the patient can return to a normal life.
Chelan M. Keeter, BSE, CNA, is an engineer for the New York Department of Transportation. She is planning to enroll in a nursing program in the fall of 2008.